BACKGROUND:The preemptive analgesia is stil a controversial issue. Existing studies have not paid much attention to effects of preoperative factors on the hypersensitivity of peripheral and central mechanisms. Visual analog scale scores cannot subjectively and repeatedly reveal patient’s pain.
OBJECTIVE:To investigate the validity of the preventive analgesia effect of Celebrex in patients with total knee arthroplasty.
METHODS:Patients with osteoarthritis of the knee who received total knee arthroplasty were accessed by Pittsburgh sleep quality index, self-rating depression scale and self-rating anxiety scale. In al , thirty patients were enrol ed in the study. They were randomized into Celebrex group and vitamin C group, and each group had 15 patients. The patients in the Celebrex group and vitamin C group took 200 mg Celebrex and vitamin C, respectively, twice a day from day 2 to day 4. Both of their knees were evaluated by resting visual analogue scale and moving visual analogue scale in the evening of day 1 before treatment and day 3 after treatment. Meanwhile, the pain threshold and pain tolerance were accessed by a pain-threshold machine.
RESULTS AND CONCLUSION:No statistical significance of the changes of resting and moving visual analogue scale scores was found in both knees in the Celebrex group (P>0.05). The pain threshold of both knees were significantly increased (P<0.05), and the severe knee, which had less visual analogue scale scores than the minor one, turned out to increase more obviously than the minor knee (P>0.05). There were no significant changes in the pain tolerance in both knees (P>0.05). The changing values of resting or moving visual analogue scale were not significantly correlated with the pain threshold and pain tolerance (P>0.05). There were no significant changes in visual analogue scale scores, pain threshold and pain tolerance in both knees of the vitamin C group (P>0.05). Celebrex could increase the pain threshold of patients receiving total knee arthroplasty, especial y the severe knee, which indicates that the Celebrex is good for the preventive analgesia. Comparatively speaking, the pain threshold might be more sensitive than visual analogue scale in revealing the change of pain after analgesia. There is no significant correlation between visual analogue scale score and the hypersensitivity of pain.

Objective To characterize the female urinary microbiome associated to OAB (overactive bladder) and investigate relationships between urinary microbiome and psychological factors.Methods 30 women with OAB and 25 asymptomatic controls were recruited and required to finish the overactive bladder symptom score,self-rating anxiety scale,self-rating depression scale and quality of life questionaires.Urine specimens were collected by transurethral catheterization and processed for 16S rRNA gene sequencing.Sequencing reads were processed using QIIME.Analyses for bacterial genera biomarker was used LEfSe algorithms.Bivariate correlations were assessed using Pearson's correlation.Results The two cohorts showed no significance difference in their demographic characteristics.OAB patients had significantly higher scores on overactive bladder symptom score,self-rating anxiety scale,self-rating depression scale and quality of life than controls (P ＜ 0.001).We found that bacterial diversity (Chao1 index:1 854.09 ± 1 239.34) and richness (Simpson index:0.75 ±0.23) were decreased in OAB samples than those of controls (Chao1 index:2 866.27 ± 1 795.22;Simpson index:0.86 ± 0.12;P =0.02).At the family level,Enterobacteriaceae and (17.6％ vs.8.1％;P =0.03) Bifidobacteriaceae (14.8％ vs.3.6％;P =0.01) were significantly more abundant in the OAB samples than the controls.Compared to controls,7 genera increased in OAB patients (e.g.,Proteus and Aerococcus) and 13 reduced (e.g.,Lactobacillus and Prevotella).There are negative correlations between scores on Self-Rating Depression Scale and both Chao1 (r =-0.458,P =0.011) and shannon indexes (r =-0.516,P =0.003) in OAB patients,which indicates that OAB patients with depression have further reductions in bacterial diversity and richness.Conclusions The aberrant urinary microbiome may serve as disease biomarkers and potential therapeutic targets of OAB.A negative correlation between depression scores and both bacterial richness and diversity in OAB patients indicated that there might be a connection between central nervous system and urinary microbiome.

Objective To explore the relationships among the central nervous system,the lower urinary tract and urinary microbiome by a rat model of stress-induced voiding dysfunction.Methods Rats were randomly assigned to stress group (exposure to water-avoidance stress for 10 days),stress-withdrawal group (exposure to the stress and then withdrawal for 2 weeks) or control group.On day 11 for stress and control groups or 2 weeks after day 11 for stress-withdrawal group,the Light-dark box transition test,lower abdominal pain threshold,micturition frequency and cystometry measurements were determined.Urine specimens were collected and processed for 16S rDNA gene sequencing.Results Compared to control group,the water-avoidance stress dramatically decreased in the time spent in the light area (P ＜0.01) and decreased mechanical pain threshold in stress group,which were reversed in stress-withdrawal group.While there was no significant difference in the micturition frequency between the control and stress-withdrawal groups,the stress group (20.33 ± 3.77) showed significantly more micturition frequencies than control (8.14 ± 2.23) and stress-withdrawal group (9.67 ± 1.89) (P ＜ 0.01).The stress dramatically increased voiding contractions in both the stress (7.33 ± 1.79) and stress-withdrawal (4.83 ± 1.06) groups compared to control rats (2.71 ± 1.38) (P ＜ 0.05).However,the stress-withdrawal group showed less voiding contractions than the stress group (P =0.03).The bacteria diversity in stress group were dramatically higher than those of the other two groups (P ＜ 0.01).Almost all specimens of the control rats were dominated by Enterococcacae,whereas samples from the stress group contained more diverse bacteria.The diversity of microbiota in the stress-withdrawal group was between those of the other two groups.LEfSe identified genera differed significantly among groups:Lactococcus and Proteus were significantly increased in in the stress-withdrawal group;Halomonas,Aggregatibacter,Haemophilus,Pseudomonas and Streptococcus were significantly higher in the stress group.Conclusions Water-avoidance stress experiments demonstrated the impact of stress on bladder function and urinary microbiome,which tended to be ameliorated after a two-week withdrawal from stress.Further research is needed to understand the connections between central nervous system,bladder and urinary microbiome.

Objective To study the effect of autologous bone marrow mesenchymal stem cells in the treatment of osteonecrosis .Methods 56 cases of osteonecrosis of femeral head ( ONFH) were treated with autologous bone marrow mesenchymal stem cells .DSA observed neovascularization after transplantation ,morphological changes of femoral head were observed by imaging method .Results Of the 30 patients who underwent autologous bone marrow stem cell transplantation,86.6％had resuscitation of hip pain,23.3％ had improved hip function,and 85.7％ had walking distance .Examination showed that the arterial artery was significantly increased before transplantation , thickening,faster blood flow.The femoral head area of the bone was significantly improved (100.0％) after 12 -24 months.Conclusion The method of transplantation of bone marrow mesenchymal stem cells is simple ,safe and effective.It is effective for stage I and II of the avascular necrosis of the femoral head .

Objective To explore the curative effect and complication of transcutaneous transcatheter uterine arterial embolization in the treatment of postpartum hemorrhage .Methods 76 cases with postpartum hemorrhage of conservative treatment invalid in the General Hospital of Huainan Oriental Hospital Group from January 2011 to January 2017 , received digital subtraction angiography ( DSA ) to make clear the site of hemorrhage , then bilateral uterine artery embolization was given .Results Seventy -six patients have stopped bleeding immediately after embolization,3 cases were significantly reduced .Bleeding stopped completely after nearly one week of treatment .Mild fever after embolization appearred unable to pain in the lower abdomen ,1 case had hip pain .Conclusion Transcuta-neous transcatheter uterine artery embolization in the treatment of postpartum hemorrhage has advantages of quick hemostasis,less trauma,less complications and preserving the uterus fertility ,which has high clinical value .

Objective To investigate the effect of bilateral internal iliac artery balloon occlusion in cesarean section for dangerous placenta previa and placenta implantation.Methods From January 2011 to December 2016,The clinical data of 15 cases of dangerous placenta previa and placenta implantation were retrospectively analyzed in the General Hospital of Huainan Oriental Hospital Group.All patients underwent internal iliac arterial intubation prior to cesarean section and into the balloon,placed the balloon in the bilateral internal iliac artery,and filled the balloon to temporarily block internal iliac arterial blood flow.The number of hysterectomy cases of cesarean sections were recorded.Results The amount of intraoperative hemorrhage was about 200-4 000mL,average 1 500mL.Intraoperative,postoperative red blood cell was 0-3 000mL,average 1 000mL,there were no maternal and fetal death and serious complications,2 cases in hysterectomy,the resection rate was 10.8％.Conclusion Bilateral internal iliac arterial balloon occlusion can effectively control the bleeding of the dangerous placenta previa during cesarean section and reduce the hysterectomy.The radiation dose is safe for the fetus.

Objectives:To investigate the clinical impacts of chronic total occlusion (CTO) in acute non-ST segment elevation myocardial infarction (NSTEMI) patients underwent primary percutaneous coronary intervention (PCI).Methods:A total of 2 271 acute NSTEMI patients underwent primary PCI from China Acute Myocardial Infarction Registry were enrolled in this study and divided into the CTO group and the non-CTO group according to the angiography. The primary endpoint was in-hospital mortality and mortality during a 2-year follow-up. The secondary endpoint was major adverse cardiovascular events (MACE) including revascularization, death, re-myocardial infarction, heart failure readmission, stroke and major bleeding.Results:Thirteen-point four percent of the total acute NSTEMI patients had concurrent CTO. In-hospital mortality (3.6% vs. 1.4%, P<0.01) and 2-year mortality (9.0% vs. 5.1%, P<0.01) were significantly higher in the CTO group than those in the non-CTO group, respectively. Multiple regression analyses showed that chronic obstructive pulmonary disease ( HR 7.28, 95% CI 1.50-35.35, P=0.01) was an independent risk factor of in-hospital mortality, and advanced age ( HR 1.04, 95% CI 1.01-1.07, P<0.01), and low levels of ejection fraction ( HR 0.95, 95% CI 0.93-0.98, P<0.01) were independent risk factors of 2-year mortality. CTO ( HR1.67, 95% CI 1.10-2.54, P=0.02) was an independent risk factor of revascularization, but not a risk factor of mortality. Conclusions:Although acute NSTEMI patients concurrent with CTO had higher mortality, CTO was only an independent risk factor of revascularization, but not of mortality. Advanced age and low levels of ejection fraction were independent risk factors of long-term death among acute NSTEMI patients.

OBJECTIVE: To establish the norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents. METHODS: Using a multistage stratified sampling method, we conducted a large-scale epidemiological investigation among 15 066 urban residents sampled from 6 regions in China, including Tianjin City (north China), Guangdong Province (south China), Anhui Province (central south China), Sichuan Province (southwest China), Lanzhou City (northwest China) and Harbin City (northeast China). The mean, percentile and threshold norms were established based on the characteristics of SHMS V1.0 scores for Chinese urban residents. RESULTS: The mean and percentile norms of total, physical, mental and social sub-health of Chinese urban residents were established according to gender and different age groups (14-19, 20-29, 30-49, 50-64 and ≥65 years). The threshold norms of SHMS V1.0 divided 5 health states, namely disease, severe sub-health, moderate subhealth, mild sub-health and healthy states according to the ± and ±0.5 of the converted scores. CONCLUSIONS The norms of Sub-Health Measurement Scale (SHMS V1.0) for Chinese urban residents were established, which provides a reference for rapid screening and diagnosis of sub-health status in Chinese urban residents and facilitates further study of the prevalence and contributing factors of sub-health.
Asian Continental Ancestry Group ; China ; Health Status ; Humans ; Prevalence ; Surveys and Questionnaires ; Urban Health ; Urban Population